All the roles have apparently viable internal candidates in NHSE and I. None are being directly transferred, with most of the current national directors placed at risk of redundancy, and invited to apply for relevant roles.

It is not known whether any have received indications they are likely to get them. However, headhunting firms have been hired for the CFO and regional director roles, but not for the others.

Some senior figures involved in the process have expressed concern to HSJ about the process and delays, which have left the current directors in a long period of uncertainty. Those affected were told they were at risk early in the summer, several months after early details of the senior structure were announced in March. The formal consultation with those affected has also been extended during the process.

In May, the organisations said: “We will make the changes to the most senior roles (at a minimum, roles reporting to the two CEOs) by September and to the changed roles at the next level during the autumn. We will continue to move quickly so as to minimise the period of uncertainty for colleagues while minimising the risk to the system of a lack of continuity. We are aiming for all changes to be made by the end of this financial year.”

The closing dates on the advertised jobs are in early October.

HSJ was told NHSE and I wanted to advertise all the roles to ensure they are open to a wider field, and that part of the reason for delay to the process was approvals from government.

Restructure

Under the restructure, NHSE and I are moving to seven joint regional teams, from the existing five. In the south east and south west – whose areas will stay the same – there are already joint RDs in place, and there are five other substantive RDs across both organisations at present. All seven RD posts are open to advert, however.

The job advert says they will “report to the two CEOs”, Simon Stevens and Ian Dalton, “and be full members of this national NHS executive group”. In NHSE regional directors have so far reported to national director for operations and information Matthew Swindells.

It says: “This is a move to a different kind of local leadership of the NHS, where regional directors promote, challenge, encourage and support local systems to achieve more integrated and sustainable models of care… the locus of decision making will be centred on the regional directors and their teams.”

In relation to the national directors, NHS England chief financial officer Paul Baumann is leaving for a new job, but has agreed to stay on longer than planned, until mid-late November, it is understood. NHSI’s finance director is Elizabeth O’Mahoney.

Chief nursing officer Jane Cummings announced her retirement this year, which would leave Ruth May as the senior substantive national nursing director across the two organisations.

There are two medical directors in post – Kathy McLean and Steve Powis at NHSI and NHSE respectively.

The other NHSI national directors, in addition to those mentioned above, have also been put at risk.

Three new roles are expected to be appointed soon but are yet to be advertised: chief provider strategy officer, chief improvement officer, and chief people officer. There are similar existing posts in NHSI to the first two.

Historically ingrained health inequalities in England won’t be reversed by measures in the long-term plan, which require bigger “political and societal” interventions, according to a public health expert whose work contributed to the plan.